Estruturação do método ABC em uma empresa de microfundição

TCC(graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Engenharia de ProduçãoO progressivo aumento na complexidade dos sistemas de produção e a alta diversidade de produtos tornam os custos relativos às atividades de suporte cada vez mais relevantes. O ABC (Activity-Based Costing/Custeio Baseado em Atividades) é uma importante ferramenta gerencial para aumento de competitividade. O método consiste em mapear os processos de uma organização e modelá-los como atividades, de forma que se possa mensurar o consumo dos recursos utilizados pelas atividades. Em seguida, são definidos os direcionadores que representam a forma com que os produtos consomem as atividades. Os direcionadores são utilizados como base para distribuir os custos das atividades para os produtos. O objetivo deste trabalho foi estruturar o ABC para aplicação em uma fábrica produtora de peças microfundidas localizada na Grande Florianópolis. A pesquisa bibliográfica deste trabalho demonstrou a existência de muitos trabalhos acadêmicos abordando a aplicação do ABC em organizações, no entanto, nenhuma aplicação em microfundições foi encontrada. Assim, o trabalho foi realizado para ampliar a discussão sobre o tema e compreender as particularidades do ABC aplicado em indústrias deste setor. Foi possível mapear todos os processos administrativos e produtivos da empresa e os modelar em atividades. Foram definidos, então, todos os direcionadores que possibilitam o custeio das atividades e dos produtos. O método foi estruturado no sistema ERP da empresa para testes e posterior implantação. Por pareceres da gerência, concluiu-se que o sistema é viável de implantação e que, futuramente, melhorias nos critérios serão implementadas.The increasing complexity of production systems and the high product diversity makes the costs of support activities increasingly relevant. Activity-Based Costing (ABC) is an important management tool for higher competitiveness. The method consists on mapping the processes of an organization and modeling them as activities, so that the consumption of resources by the activities can be measured. Then, the drivers that represent how products consume activities are defined. Finally, drivers are used as a basis for distributing activity costs to products. The objective of this research was to structure the ABC method in a investment casting company located in Grande Florianópolis. The bibliographic research about this topic has shown the existence of many academic papers addressing the application of ABC in organizations, however, no one related to investment casting was found. Thus, the work was developed to broaden the discussion on the subject and to understand the particularities of ABC applied this sector. It was possible to map all administrative and productive processes of the company and to model it in activities. Then, all the drivers that enable the costing of the activities and products were defined. The method was structured in the company's ERP system for testing and subsequent deployment. Based on management advice, it was concluded that the system is feasible to implement and that in the future improvements in the criteria will be implemented

O Mini-CEX na avaliação de habilidades clínicas na graduação médica

Introdução: Instrumentos de avaliação de habilidades clínicas na medicina são importantes para a análise do conhecimento, habilidades e atitudes do estudante. Dentre eles, o Mini Clinical Evaluation Exercise (mini-CEX) vem se destacando por avaliar o estudante em ambiente real de prática, além de fornecer feedback imediato. Objetivo: Realizar uma revisão sistemática da literatura sobre a aplicação do instrumento mini-CEX na graduação do curso de medicina. Métodos: As bases de dados pesquisadas foram: Eric, Pubmed e Science Direct. Através de duas estratégias de busca diferentes: Busca A, com período de pesquisa de 2011 a 2016 e a Busca B, com intervalo de 2006 a 2016, foram incluídos artigos que abordam o mini-CEX como instrumento de avaliação das habilidades clínicas em acadêmicos de medicina. Foram consideradas as características gerais dos estudos, o uso do mini-CEX na graduação médica e os critérios avaliados por esse instrumento. Resultados: Dos 140 artigos encontrados, três atenderam aos critérios de inclusão. Os estudos avaliaram as habilidades clínicas dos estudantes de medicina com o uso do mini-CEX, a partir da: habilidade de comunicação, atitude/profissionalismo, humanização, raciocínio clínico, habilidades de aconselhamento, organização/eficiência e competência clínica geral. Dentre essas competências, a anamnese, o exame físico e a capacidade de comunicação são melhores avaliados pelo mini-CEX quando comparado a outros métodos de avaliação de competências. Além disso, competências como comportamentos pessoal e profissional obtiveram as maiores pontuações gerais. Conclusões. O mini-CEX parece ser uma ferramenta eficaz, de fácil aplicação e confiável na avaliação das habilidades clínicas dos acadêmicos de medicina.Introduction. Assessment methods of clinical skills in medicine are important for the analysis of students’ knowledge, skills and attitudes. Among these methods, the Mini Clinical Evaluation Exercise (mini-CEX) has been highlighted for evaluating the student in real practice environment, in addition to providing immediate feedback. Objective. To conduct a systematic review of the literature of the application of Mini Clinical Evaluation Exercise instrument in medical school graduation. Methods. Eric, Pubmed and Science Direct were searched. Through two differents search strategies: Search A, with publications from 2011 to 2016, and Search B, with publications from 2006 to 2016, including articles with mini-CEX as an instrument for evaluating clinical skills in medical students. General characteristics of the studies, the use of the mini-CEX in medical graduation and the evaluated abilities were examined. Results. Of the 140 studies identified, 3 met the inclusion criteria. The studies evaluated clinical skills of medical students using mini-CEX, from the following: communication skills, personal and professional behavior, humanization, clinical judgement, counseling skills, organization and efficiency and overall clinical care. Among these skills, history taking, physical examination and the communication skills are best evaluated by mini-CEX when compared to other skills assessment methods. Finally, competences such as personal and professional behaviours obtained the highest overall scores. Conclusions. The mini-CEX is an effective tool, easy to apply and reliable on the evaluation of clinical skills of the medical academics

Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence

About one-third of people with major depressive disorder (MDD) fail at least two antidepressant drug trials at 1 year. Together with clinical and experimental evidence indicating that the pathophysiology of MDD is multifactorial, this observation underscores the importance of elucidating mechanisms beyond monoaminergic dysregulation that can contribute to the genesis and persistence of MDD. Oxidative stress and neuroinflammation are mechanistically linked to the presence of neurovascular dysfunction with blood-brain barrier (BBB) hyperpermeability in selected neurological disorders, such as stroke, epilepsy, multiple sclerosis, traumatic brain injury, and Alzheimer’s disease. In contrast to other major psychiatric disorders, MDD is frequently comorbid with such neurological disorders and constitutes an independent risk factor for morbidity and mortality in disorders characterized by vascular endothelial dysfunction (cardiovascular disease and diabetes mellitus). Oxidative stress and neuroinflammation are implicated in the neurobiology of MDD. More recent evidence links neurovascular dysfunction with BBB hyperpermeability to MDD without neurological comorbidity. We review this emerging literature and present a theoretical integration between these abnormalities to those involving oxidative stress and neuroinflammation in MDD. We discuss our hypothesis that alterations in endothelial nitric oxide levels and endothelial nitric oxide synthase uncoupling are central mechanistic links in this regard. Understanding the contribution of neurovascular dysfunction with BBB hyperpermeability to the pathophysiology of MDD may help to identify novel therapeutic and preventative approaches

A Systematic Review of Benefits and Risks of Fetal Surgery for Congenital Cardiac Defects Such as Pulmonary Valve Stenosis and Critical Aortic Stenosis

ABSTRACT Introduction: Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome. Methods: Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute’s Qualitative Assessment and Review Instrument (or JBI-QARI) was used for data quality appraisal. Results: Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality. Conclusion: The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon’s technical expertise and well-structured hospital facilities